Having presented as complete a picture of the judicialisation of health in Brazil as I could with the available data in Chapter 5, I now turn to the interpretation of that picture. Why has judicialisation grown so much in the past couple of decades? Why are the hundreds of thousands of cases now reaching the courts every year concentrated in the states of the South and Southeast, and mostly in some cities and districts? Who gains, and who loses, from the approximately R$7 billion (3 per cent of the total health budget) spent annually as a result of litigation? These are the main questions addressed in Chapters 6–8 in an attempt to shed some light on the drivers and social impact of health litigation in Brazil.